Question 1

A person with pulmonary hypertension has an elevated haematocrit level. What should be included in the nurse's discharge instructions?

Accepted Answer

Venesection or bloodletting may be necessary to reduce the elevated haematocrit level in patients with pulmonary hypertension. The other options listed are not specific to the management of elevated haematocrit levels.

Question 2

The nurse is assisting a person with severe COPD with menu items for daily meals while in the hospital. Which of the following items is the most beneficial for this person?

Accepted Answer

Steak with vegetables is the most beneficial option for a person with severe COPD because it provides a high protein content which is essential for maintaining muscle strength and respiratory function. Protein is particularly important for individuals with COPD to help combat muscle wasting and to support overall lung health. Vegetables offer essential vitamins and minerals, contributing to a balanced diet.

Question 3

Which of the following would be considered the type of trigger for an asthmatic patient that experiences an exacerbation when in contact with house pets?

Accepted Answer

Environmental allergens, such as dander from house pets, can trigger an asthma exacerbation in some patients. Psychosocial and emotional stress triggers may also play a role, but if the trigger is specifically related to contact with house pets, then environmental allergens would be the most appropriate choice. Physical factors, such as exercise-induced asthma, would not be relevant in this scenario.

Question 4

A person has a nasal endotracheal tube. What will this method of airway management result in?

Accepted Answer

The answer of A person has a nasal endotracheal tube....

Question 5

A person receiving heparin is found to have an extremely high partial thromboplastin time (PTT). Which of the following should be available to assist this person should bleeding occur?

Accepted Answer

Protamine is the antidote for heparin and should be available to reverse the effects of heparin and assist with bleeding if it occurs. Streptokinase and tissue plasminogen activator are thrombolytic agents used to dissolve clots and are not indicated in this situation. Vitamin K is the antidote for warfarin, another type of anticoagulant.

Question 6

A person with hypoxaemia is not improving despite oxygen therapy. Which of the following is indicated for this person?

Accepted Answer

Continuous positive airway pressure (CPAP) is indicated for a person with hypoxaemia who is not improving despite oxygen therapy. CPAP can help improve oxygenation by opening up collapsed alveoli and keeping them open during exhalation, allowing for better gas exchange. Options A and B, neuromuscular blocking agents and narcotic analgesics, are not appropriate treatments for hypoxaemia. Tracheostomy may be considered in some cases, but it is not the first-line treatment for hypoxaemia.

Question 7

A person is prescribed a medication to reduce the need for inhaled corticosteroids while controlling asthma symptoms. What category of medication is this?

Accepted Answer

Leukotriene receptor antagonists are medications used to control asthma symptoms and reduce the need for inhaled corticosteroids. They work by blocking the action of leukotrienes, which are substances released by the body in response to allergens that cause inflammation in the airways. Mast cell stabilizers also help control asthma symptoms but do not reduce the need for inhaled corticosteroids. Anticholinergics and adrenergic stimulants are used to treat other respiratory conditions but are not typically used to reduce the need for inhaled corticosteroids in asthma treatment.

Question 8

A person is diagnosed with sarcoidosis. What should be included as appropriate teaching for this person? Select all that apply.

Accepted Answer

A person with sarcoidosis should avoid anything that irritates the respiratory tract as it can worsen symptoms. They should quit smoking as it can also exacerbate symptoms and lead to further complications. Reporting any onset of shortness of breath is important, as it can be a sign of worsening disease. However, limiting simple carbohydrates is not directly associated with sarcoidosis management, so it is not an appropriate teaching for this condition.

Question 9

Which of the following is the most appropriate nursing action for an extubated patient that presents with respiratory stridor?

Accepted Answer

Respiratory stridor after extubation is a sign of airway obstruction, which can quickly progress to respiratory distress and failure. Therefore, the most appropriate nursing action is to be prepared for re-intubation and ensure the patient's airway is secured. Close monitoring and collaboration with the healthcare team are also essential.

Question 10

An intubated person is awake and begins to cry. What is the nurse's best action?

Accepted Answer

The nurse should communicate with the person and explain the situation, as they can likely still hear and understand despite being intubated. This can help alleviate anxiety and provide reassurance, while also preparing them for the possibility of extubation in the future. Option A is not the best action because emotional support and communication are key components of nursing care. Option B may be appropriate in certain situations, but should not be the first response to crying. Option C may be appropriate for promoting rest, but does not address the person's emotional needs.

Question 11

The nurse is instructing a person to breathe to help maintain open airways during exhalation. What technique is the nurse teaching the person?

Accepted Answer

Pursed-lip breathing is a technique that involves inhaling through the nose and exhaling slowly through pursed lips. This helps to maintain open airways during exhalation and can be helpful for people with respiratory conditions such as COPD. Controlled breathing, diaphragmatic breathing, and huff breathing are all techniques that may be used to improve breathing, but they do not specifically focus on maintaining open airways during exhalation.

Question 12

The nurse is providing care to a person with cystic fibrosis. Which of the following interventions would help prevent the onset of an acute illness?

Accepted Answer

Administering an immunization would help prevent the onset of an acute illness in a person with cystic fibrosis. Immunizations are recommended to prevent respiratory infections in people with cystic fibrosis, as they are at a higher risk for these infections due to their compromised lung function. Restricting fluid intake, monitoring white blood cell count, and providing prophylactic anti-inflammatory therapy are not necessarily interventions to prevent acute illness in cystic fibrosis.

Question 13

What can be expected of a person who is receiving positive end-expiratory pressure (PEEP)?

Accepted Answer

Positive end-expiratory pressure (PEEP) is typically used in mechanically ventilated patients, which implies that the person is intubated. PEEP helps to keep the alveoli open during the expiratory phase of ventilation, improving oxygenation in patients with severe respiratory distress or failure.

Question 14

A person is believed to have a pulmonary embolism that was not diagnosed after a lung CT scan. Which of the following is an appropriate diagnostic test for this person?

Accepted Answer

Pulmonary angiography is the gold standard diagnostic test for pulmonary embolism. It involves injecting a dye into the pulmonary artery and taking X-rays to identify any blockages. A lung scan may also be used as a diagnostic test. Chest X-rays are not sensitive or specific for diagnosing pulmonary embolism, and coagulation studies may be helpful in identifying risk factors for thrombosis but do not aid in the diagnosis of embolism.

Question 15

Which of the following would be the COPD classification of a person that presents with few symptoms and is left breathless on exertion?

Accepted Answer

According to the GOLD (Global Initiative for Chronic Obstructive Lung Disease) classification of COPD, a person with few symptoms, but breathless on exertion would be classified as having 'Mild' COPD. This is characterized by FEV1 (forced expiratory volume in one second) between 60% and 80% of predicted value.

Question 16

The nurse is positioning a person with atelectasis. Which of the following positions is the most beneficial for this person?

Accepted Answer

Positioning the lung without atelectasis lower than the lung with atelectasis helps improve ventilation to the healthier lung and promotes better oxygenation. This position utilizes gravity to enhance perfusion to the healthier lung, which can improve overall lung function and facilitate the resolution of atelectasis.

Question 17

A 65-year-old male who continues to smoke tells the nurse that he is fine because he only has chronic bronchitis. The nurse determines that this person is most likely experiencing what condition?

Accepted Answer

Chronic bronchitis is a type of chronic obstructive pulmonary disease (COPD) that results in inflammation and narrowing of the airways. It is often caused by smoking and can lead to other COPD conditions such as emphysema and cor pulmonale. Atelectasis refers to the collapse or closure of a lung or a part of a lung, which can also be caused by smoking. However, chronic bronchitis is a more likely diagnosis in a smoker of this age.

Question 18

An intubated person is not exhibiting signs of improved oxygenation. What should the nurse do? Select all that apply.

Accepted Answer

If an intubated person is not exhibiting signs of improved oxygenation, the nurse should first check the endotracheal tube placement to ensure it is in the correct position. Then, the nurse should assess for the need to suction to clear the airway and improve oxygenation. Inserting an oral airway or preparing for an emergency tracheotomy would not be appropriate initial actions in this scenario.

Question 19

A person diagnosed with carbon dioxide retention has a pulse oximetry reading of 80% on room air. A nurse should obtain a doctor's order to do which of the following interventions?

Accepted Answer

Carbon dioxide retention means that the person is not ventilating effectively and administering high-volume oxygen will further decrease their respiratory drive. Intubation may be necessary if the person's condition deteriorates, but it should not be the first intervention. Providing an oral airway without addressing the decreased oxygen saturation would not address the issue. Administering low-volume oxygen and monitoring respirations will help improve the person's oxygen saturation without further decreasing their respiratory drive.

Question 20

A person is being instructed on the use of a metered-dose inhaler without a spacer for asthma. After firing a puff of the inhaler, how long should the person hold their breath?

Accepted Answer

Holding the breath for about 10 seconds after firing a puff from a metered-dose inhaler allows the medication to deposit in the lungs more effectively.

Quiz 36: Nursing Care of People With Gas Exchange Disorders